Innovating to protect the rights of people who use drugs

I have just spent a week in Nigeria getting to see and understand the work we are engaged in through the Innovate, Involve and Inspire programme, as well as meeting partners and other stakeholders. The pilot programme aims to prevent, test and treat hepatitis C through community-led harm reduction, and works with people who use drugs in Egypt, Kyrgyzstan and Nigeria.  

This includes the use of ‘low dead space’ syringes, which reduce the amount of space within the syringe for blood to enter, to lower the likelihood of infection. 

We are first launching the pilot programme in Gombe, Nigeria. If we can get it right in Gombe, it can be rolled out in the rest of Nigeria. It involves the government working with civil society organisations and networks of people who use drugs. This pilot research aims to influence WHO guidelines on testing and treating hepatitis C in lower and middle-income countries. The hope is that these models will be replicated and scaled up in other countries and contexts.

Innovation

In this way we are innovating in an area that impacts on many people living with HIV, and hepatitis C, which is often a co-infection of HIV. The work brings together a rich alliance of stakeholders drawn from communities of drug users, civil society, government, and the private sector. 

In Gombe State, the main location of the programme in Nigeria, I met an impressive group of leaders driving forward change of a remarkable kind. 

Aneidi Akpan, Executive Director of the Drugs Advice Prevention Health Organisation (DAPHO), the lead delivery organization in Gombe, has been on a mission to prove that people who inject drugs exist in significant numbers in the region.

He set up DAPHO in Gombe in 2013 where he was first able to bring this reality to public attention. Aneidi credits the seed funding he received from the PITCH programme for a computer and printer, which led to the birth of his organisation. The Partnership to Inspire, Transform and Connect the HIV response (PITCH), was a five-year project which ended in 2020 which focused on community-led advocacy. 

DAPHO’s rich association with Frontline AIDS is the driving force for the work in Gombe State. The success of the programme depends on a number of other stakeholders. I met with the inspiring Dr Habu Dahiru, Honourable Commissioner at the State Ministry of Health, as well as Dr Mu’Azu Shuaibu, the Chief Medical Officer at the Gombe State Specialist Hospital. 

Both are playing courageous roles in paving the way for this groundbreaking innovation in the fight against hepatitis C and the rights of drug users. And both took time out to attend the Innovate, Involve and Inspire stakeholder coordination meeting in Cairo, the only senior government stakeholders present at the event. 

There is much work to be done to get the programme up and running. It has been a slow burn so far, involving extensive work to get clearance for the use of direct acting anti-viral drugs. These block the action of proteins which are essential for making new hepatitis C viruses. The team will administer these from the lab set up in the DAPHO office with the approval of the State Specialist Hospital. 

Nothing of its kind has taken place in Nigeria and it’s very rare in sub-Saharan Africa, so it is an exciting moment for this innovative programme supported by Unitaid. 

There will be work in the coming months once the testing and treatment is up and running, and before the data on initial findings of the pilot study are available to communicate. Once we have that, we’ll share lessons learnt more widely.

Partnerships

I came away from the visit with the realisation that the programme is in many ways a microcosm of what we do at Frontline AIDS. We aim to share learning and innovation across the largest global partnership of community and civil society organisations working together to end AIDS, everywhere.

The programme is delivered in association with Frontline AIDS partners who lead on delivery in one of the three countries: Alliance for Public Health (APH) from Ukraine, who play a lead role on harm reduction and are the lead organisation for the work in Kyrgyzstan; Menara from Lebanon, who lead the work in Egypt, and Education is a Vaccine (EVA) in Nigeria. 

This is just one example of Frontline AIDS’ work. There are many stories from around the world that we will be showcasing to mark World AIDS Day 2024. We’ll celebrate our partners and their work on the frontline in Cambodia, Guatemala, Nigeria, Paraguay, and beyond.

We believe that 2030 is possible. 

John Plastow is the Executive Director of Frontline AIDS.